Microstructural white matter damage on MRI is associated with disease severity in Dutch-type cerebral amyloid angiopathy.

IF 4.9 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Journal of Cerebral Blood Flow and Metabolism Pub Date : 2024-11-01 Epub Date: 2024-06-17 DOI:10.1177/0271678X241261771
Ingeborg Rasing, Naomi Vlegels, Manon R Schipper, Sabine Voigt, Emma A Koemans, Kanishk Kaushik, Rosemarie van Dort, Thijs W van Harten, Alberto De Luca, Ellis S van Etten, Erik W van Zwet, Mark A van Buchem, Huub Am Middelkoop, Geert Jan Biessels, Gisela M Terwindt, Matthias Jp van Osch, Marianne Aa van Walderveen, Marieke Jh Wermer
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Abstract

Peak width of skeletonized mean diffusivity (PSMD) is an emerging diffusion-MRI based marker to study subtle early alterations to white matter microstructure. We assessed PSMD over the clinical continuum in Dutch-type hereditary CAA (D-CAA) and its association with other CAA-related MRI-markers and cognitive symptoms. We included (pre)symptomatic D-CAA mutation-carriers and calculated PSMD from diffusion-MRI data. Associations between PSMD-levels, cognitive performance and CAA-related MRI-markers were assessed with linear regression models. We included 59 participants (25/34 presymptomatic/symptomatic; mean age 39/58 y). PSMD-levels increased with disease severity and were higher in symptomatic D-CAA mutation-carriers (median [range] 4.90 [2.77-9.50]mm2/s × 10-4) compared with presymptomatic mutation-carriers (2.62 [1.96-3.43]mm2/s × 10-4) p = <0.001. PSMD was positively correlated with age, CAA-SVD burden on MRI (adj.B [confidence interval] = 0.42 [0.16-0.67], p = 0.002), with number of cerebral microbleeds (adj.B = 0.30 [0.08-0.53], p = 0.009), and with both deep (adj.B = 0.46 [0.22-0.69], p = <0.001) and periventricular (adj.B = 0.38 [0.13-0.62], p = 0.004) white matter hyperintensities. Increasing PSMD was associated with decreasing Trail Making Test (TMT)-A performance (B = -0.42 [-0.69-0.14], p = 0.04. In D-CAA mutation-carriers microstructural white matter damage is associated with disease phase, CAA burden on MRI and cognitive impairment as reflected by a decrease in information processing speed. PSMD, as a global measure of alterations to the white matter microstructure, may be a useful tool to monitor disease progression in CAA.

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核磁共振成像上的白质微结构损伤与荷兰型脑淀粉样血管病的病情严重程度有关。
骨架化平均弥散度峰值宽度(PSMD)是一种新兴的基于弥散成像的标记,用于研究白质微观结构的早期微妙改变。我们评估了荷兰型遗传性 CAA(D-CAA)中 PSMD 的临床连续性及其与其他 CAA 相关 MRI 标记和认知症状的关联。我们纳入了有症状的D-CAA突变携带者,并根据弥散磁共振成像数据计算了PSMD。通过线性回归模型评估了 PSMD 水平、认知表现和 CAA 相关 MRI 标志物之间的关联。我们共纳入了 59 名参与者(25/34 为无症状/有症状;平均年龄为 39/58 岁)。有症状的 D-CAA 基因突变携带者(中位数 [范围] 4.90 [2.77-9.50]mm2/s × 10-4)与无症状的基因突变携带者(2.62 [1.96-3.43]mm2/s × 10-4)相比,PSMD 水平随着疾病严重程度的增加而升高。
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来源期刊
Journal of Cerebral Blood Flow and Metabolism
Journal of Cerebral Blood Flow and Metabolism 医学-内分泌学与代谢
CiteScore
12.00
自引率
4.80%
发文量
300
审稿时长
3 months
期刊介绍: JCBFM is the official journal of the International Society for Cerebral Blood Flow & Metabolism, which is committed to publishing high quality, independently peer-reviewed research and review material. JCBFM stands at the interface between basic and clinical neurovascular research, and features timely and relevant research highlighting experimental, theoretical, and clinical aspects of brain circulation, metabolism and imaging. The journal is relevant to any physician or scientist with an interest in brain function, cerebrovascular disease, cerebral vascular regulation and brain metabolism, including neurologists, neurochemists, physiologists, pharmacologists, anesthesiologists, neuroradiologists, neurosurgeons, neuropathologists and neuroscientists.
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